MEDICARE: WATERMARK MEDICAL, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QS1200X	Sleep Disorder Diagnostic Clinic/Center		GA

General Provider Information

NPI Number	:	1063748671
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WATERMARK MEDICAL, INC.

Provider Business Mailing Address
First Line	:	600 ATLANTIS RD
Second Line	:
City	:	MELBOURNE
State	:	FL
Zip	:	32904-2315
Country	:	US
Telephone Number	:	321-821-2032
Fax Number	:

Provider Business Practice Location Address
First Line	:	1117 PERIMETER CENTER WEST
Second Line	:	SUITE W514
City	:	ATLANTA
State	:	GA
Zip	:	30338
Country	:	US
Telephone Number	:	877-710-6999
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	STEVE FELDMAN
Credential	:
Telephone Number	:	321-676-0010

Provider Enumeration Date	:	11/02/2009
Last Update Date	:	04/15/2026

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